Effects of the Support Surface Condition on Muscle Activity of Trunk Muscles during Balance Exercises in Patients with Stroke

  • Jung, Kyoung-Sim (Department of Physical Therapy, The Graduated School, Sahmyook University) ;
  • Kim, Yong-Su (Department of Physical Therapy, Health Cluster, Shinsung University) ;
  • In, Tae-Sung (Department of Physical Therapy, The Graduated School, Sahmyook University)
  • 투고 : 2015.07.23
  • 심사 : 2015.08.21
  • 발행 : 2015.08.25

초록

Purpose: The purpose of this study was to examine the muscle activity of the trunk muscles during balance exercises on a stable and unstable surface in patients with stroke. Methods: Thirteen subjects (8 males, 5 females) with stroke were enrolled in the study. Muscle activity was recorded using surface EMG electrodes from the affected side of the erector spinae, external oblique, and internal oblique muscles. The exercise was performed under three conditions. For the first condition for balance exercise, subjects were instructed to sit on an exercise mat with legs extended. The second condition was to sit with legs extended, with a balance pad under their buttocks. The third condition was to sit with legs extended, have a balance pad under the buttocks and a balance cushion under the lower legs. Results: This study showed significant differences in EMG activities during both arm lifting exercise and weight shifting exercise between conditions. This study showed that the EMG activities of the erector spinae, external oblique, and internal oblique muscles were significantly higher when the trunk exercise was performed using the balance pad with balance ball than when using the stable surface. Conclusion: In conclusion, performing balance exercises using an unstable surface is a useful method for facilitating trunk-muscle strength and hence trunk stability.

키워드

참고문헌

  1. Verheyden G, Nieuwboer A, Mertin J et al. The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18(3):326-34. https://doi.org/10.1191/0269215504cr733oa
  2. Seo HJ, Kim JH, Choi MJ et al. The effects of gluteal taping on pelvic alignment, trunk stability, and balance during sitting in children with unilateral cerebral palsy. J Kor Phys Ther. 2014;26(5):308-14.
  3. Verheyden G, Nieuwboer A, De Wit L et al. Time course of trunk, arm, leg, and functional recovery after ischemic stroke. Neurorehabil Neural Repair. 2008;22(2):173-9. https://doi.org/10.1177/1545968307305456
  4. van de Port IG, Kwakkel G, Schepers VP et al. Predicting mobility outcome one year after stroke: A prospective cohort study. J Rehabil Med. 2006;38(4):218-23. https://doi.org/10.1080/16501970600582930
  5. Deutsch JE, Merians AS, Adamovich S et al. Development and application of virtual reality technology to improve hand use and gait of individuals post-stroke. Restorative neurology and neuroscience. 2004;22(3):371-86.
  6. Yeom JN, Lim CG. Change of statics and dynamic foot pressure after trunk stabilization exercises in children with spastic diplegic cerebral palsy. J Kor Soc Phys Ther. 2014;26(4):274-9.
  7. Dickstein R, Shefi S, Marcovitz E et al. Anticipatory postural adjustment in selected trunk muscles in post stroke hemiparetic patients. Arch Phys Med Rehabil. 2004;85(2):261-7. https://doi.org/10.1016/j.apmr.2003.05.011
  8. Lanzetta D, Cattaneo D, Pellegatta D et al. Trunk control in unstable sit-ting posture during functional activities in healthy subjects and patients with multiple sclerosis. Arch Phys Med Rehabil. 2004;85(2):279-83. https://doi.org/10.1016/j.apmr.2003.05.004
  9. Karthikbabu S, Nayak A, Vijayakumar K et al. Comparison of physio ball and plinth trunk exercises regimens on trunk control and functional balance in patients with acute stroke: a pilot randomized controlled trial. Clin Rehabil. 2011;25(8):709-19. https://doi.org/10.1177/0269215510397393
  10. van Nes IJ, Nienhuis B, Latou H et al. Posturographic assessment of sitting balance recovery in the subacute phase of stroke. Gait Posture. 2008;28(3):507-12. https://doi.org/10.1016/j.gaitpost.2008.03.004
  11. Feldwieser FM, Sheeran L, Meana-Esteban A. Electromyographic analysis of trunk-muscle activity during stable, unstable and unilateral bridging exercises in healthy individuals. Eur Spine J. 2012;21(Suppl 2):S171-86. https://doi.org/10.1007/s00586-012-2254-7
  12. Marshall PW, Murphy BA. Core stability exercises on and off a Swiss ball. Arch Phys Med Rehabil. 2005;86(2):242-9. https://doi.org/10.1016/j.apmr.2004.05.004
  13. Park YS. The effect of affected side trunk muscle activity in hemiplegia during asymmetrical bridging exercise with each different knee joint angles. Deagu Catholic University. Dissertation of Master's Degree. 2012.
  14. Park MC. The effects of bridge exercise with different knee joint angles on stroke patients trunk muscle activity at different knee joint angle. Hallym University. Dissertation of Master's Degree. 2012.
  15. Shim HB, Cho HY, Choi WH. Effects of the trunk stabilization exercise on muscle activity in lumbar region and balance in the patients with hemiplegia. J Kor Soc Phys Ther. 2014;26(1):33-40. https://doi.org/10.1589/jpts.26.33
  16. Jung KS, Chung YJ. Effects of the support surface condition on muscle activity of trunk muscles during weight shifting exercise. J Kor Soc Phys Ther. 2012;24(5):300-5.
  17. Cram JR, Kasman GS, Holtz. Introduction to surface electro myography. Washington. Aspen publishers. 1993.
  18. Bouisset S, Zattara M. Biomechanical study of the programming of anticipatory postural adjustments associated with voluntary movement. J Biomech. 1987;20(8):735-42. https://doi.org/10.1016/0021-9290(87)90052-2
  19. Horak FB, Esselman P, Anderson ME et al. The effects of movement velocity, mass displaced, and task certainty on associated postural adjustments made by normal and hemiplegic individuals. J Neurol Neurosurg Psychiatry. 1987;47(9):1020-8. https://doi.org/10.1136/jnnp.47.9.1020
  20. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):S86-92.
  21. Barr KP, Griggs M, Cadby T. Lumbar stabilization: Core concepts and current literature, Part 1. Am J Phys Med Rehabil. 2005;84(6):473-80. https://doi.org/10.1097/01.phm.0000163709.70471.42
  22. Dean CM, Shepherd RB. Task-related training improves performance of seated reaching tasks after stroke. A randomized controlled trial. Stroke. 1997;28(4):722-8. https://doi.org/10.1161/01.STR.28.4.722
  23. Carr LJ, Harrison LM, Stephens JA. Evidence for bilateral innervation of certain homologous motoneurone pools in man. J Physiol. 1994;475(2):217-27. https://doi.org/10.1113/jphysiol.1994.sp020063
  24. Ferbert A, Caramia D, Priori A et al. Cortical projection to erector spinae muscles in man as assessed by focal transcranial magnetic stimulation. Electroencephalogr Clin Neurophysiol. 1992; 85(6):382-7. https://doi.org/10.1016/0168-5597(92)90051-C
  25. Verheyden G, Vereeck L, Truijen S et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin rehab. 2006;20(5):451-8. https://doi.org/10.1191/0269215505cr955oa